Peanut’s medical thread
I just need a quick confirmation on Azithromycin dosing. Peanut is having a bout of what we believe is pneumonia. The vet put her on Azithromycin 200mg/5mL. When he asked me if I knew how to dose it, I said “it’s 1mL/kg, right?” He says absolutely not, never give her more than 0.1 mL. Peanut is just at 1.2 kg. That seems CRAZY low dose to me. Nothing I’ve read says anything about that low of a dose, unless I’m totally confused and reading everything wrong. Should I not be giving her 1.2mL?
- Sef
- I dissent.
According to the 5th edition of James Carpenter's Exotic Animal Formulary, Azithromycin has a dosage range of 15-30mg/kg.
The Azithromycin you have is 200mg/5ml, which is 40 milligrams for every milliliter.
At a weight of 1.5kg, Peanut will need roughly 30 milligrams of the drug (if I use a middle-of-the-road dose of 20mg/kg).
That amount will be found in 0.75cc's of the concentration that you have. So, your vet would be correct based on what I have calculated.
The Azithromycin you have is 200mg/5ml, which is 40 milligrams for every milliliter.
At a weight of 1.5kg, Peanut will need roughly 30 milligrams of the drug (if I use a middle-of-the-road dose of 20mg/kg).
That amount will be found in 0.75cc's of the concentration that you have. So, your vet would be correct based on what I have calculated.
Sef, I saw that dosing in Plumb’s Handbook as well. I think the 1mL/kg came from Simon Maddock and had been used to dose Azithromycin on a UK guinea pig forum which is where I saw that’s what their vets had been prescribing. I’m not sure where they got that dosing, but would definitely rather dose lower with the 15-30mg/kg to be on the safe side.
But either dosing method is still a lot more than 0.1mL and that’s what I want to be sure of. I was starting to think it was like when the new batrim was being prescribed and it was a much higher concentration and maybe I’d accidentally gotten a stronger concentration than what was used in other calculations, but it’s definitely 200mg/5mL. Hopefully the vet just was thinking of the dose for some other med on accident. He seemed to be in a really odd headspace as it was today, as it was lol
But either dosing method is still a lot more than 0.1mL and that’s what I want to be sure of. I was starting to think it was like when the new batrim was being prescribed and it was a much higher concentration and maybe I’d accidentally gotten a stronger concentration than what was used in other calculations, but it’s definitely 200mg/5mL. Hopefully the vet just was thinking of the dose for some other med on accident. He seemed to be in a really odd headspace as it was today, as it was lol
- Sef
- I dissent.
I'm sorry; I misread that your vet said "never more than 0.1ml." That doesn't make sense. Can you call tomorrow and ask to double-check what was meant by that? It makes me wonder if either the bottle was labeled incorrectly as 200mg/5ml (although, I have seen that concentration on Azithromycin elsewhere), or the vet was thinking 200mg/ml.
If the vet was thinking 200mg/ml (200 milligrams in each milliliter), then 0.15ml would be in line with what your vet said.
As far as the number of days, I would confirm that with your vet as well. Typically antibiotics are given anywhere between 10 to 14 days, but it largely depends on the type and severity of the condition being treated.
I would recommend using a probiotic. This particular antibiotic can be pretty hard on the gut. See:
https://www.guinealynx.info/antibiotic_advice.html
If the vet was thinking 200mg/ml (200 milligrams in each milliliter), then 0.15ml would be in line with what your vet said.
As far as the number of days, I would confirm that with your vet as well. Typically antibiotics are given anywhere between 10 to 14 days, but it largely depends on the type and severity of the condition being treated.
I would recommend using a probiotic. This particular antibiotic can be pretty hard on the gut. See:
https://www.guinealynx.info/antibiotic_advice.html
Thanks, Sef. I’ll call tomorrow on my lunch break to confirm, but I went ahead and gave her a dose tonight and followed it with Bene-Bac as always. It definitely makes a big difference on the frequency of soft poops when I’ve given it with antibiotics in the past so I’m definitely a big believer in it. Lol. He had me mix the bottle myself, he just gave me the stock bottle of powder and I mixed it with 9 mL of water, so at least I know for sure what concentration it was which makes me feel a lot better. Our vet in the area that was really good recently passed, and this vet is new to me, but I haven’t heard great things so far. The other vet I use that’s about two hours away was out of the office today due to taking a long holiday weekend, or I probably would never have gone to this one, but since she’s had URIs before I knew how bad she could get very quickly and just mostly needed him to give me meds if nothing else. Just things he said today during the visit makes me question any judgement he has with her. He never listened to her lungs or really did anything beside scratch her back and ask if I feed her vitamin C drops (which I do not, I give her veggies and sometimes supplement with vitamin C tablets if there’s a problem with veggies that day). Then he went to get a textbook to find out what might cause it. He even suggested that since the book said that they can contract yersinia pestis, she might have that because it could cause lung issues...It made me concerned because a jump to pneumonic Plague seemed pretty extreme. He says he sees all animals but I definitely didn’t get the impression he’s worked with a lot of Guinea pigs. TL;DR I’ll call tomorrow but don’t have high hopes that the information I’ll get will be much better unfortunately. :(
- Sef
- I dissent.
It sounds like you need to look around for another vet.
However, now I'm a little confused. I thought you had a liquid suspension that was 200mg/5ml. When you say you mixed with 9ml of water, are you saying that you used a powder that was 200mg/5ml and that you reconstituted it? If so, that would greatly change the concentration.
However, now I'm a little confused. I thought you had a liquid suspension that was 200mg/5ml. When you say you mixed with 9ml of water, are you saying that you used a powder that was 200mg/5ml and that you reconstituted it? If so, that would greatly change the concentration.
Yes, exactly, I just reconstituted the bottle to a final volume of 15 mL with 40mg/mL.
Unfortunately in this area, we now only have one exotic vet, which is about 2-3 hours away, and she’s the one on vacation this long weekend. The next closest exotic vet is a bit over 5 hours away and I knew I wouldn’t be able to make it there before their office closed today, and most are closed tomorrow for a long 4th of July weekend. I wouldn’t have gone to this vet had it not been for sheer desperation. Living in the middle of nowhere does not make for great vet options :/
Unfortunately in this area, we now only have one exotic vet, which is about 2-3 hours away, and she’s the one on vacation this long weekend. The next closest exotic vet is a bit over 5 hours away and I knew I wouldn’t be able to make it there before their office closed today, and most are closed tomorrow for a long 4th of July weekend. I wouldn’t have gone to this vet had it not been for sheer desperation. Living in the middle of nowhere does not make for great vet options :/
- Sef
- I dissent.
Got it. That makes sense.
Do be sure to watch for any signs of inappetence or weight loss while on the Azithromycin. We generally suggest giving a probiotic an hour or so after the antibiotic.
It is frustrating not to have access to an experienced vet. It sounds like you're doing the best you can, though. I'm in a similar situation where we live. Thankful to have our vet, who is not an exotics vet per se but has learned a lot about guinea pigs over the years; the next closest vet who knows anything about exotics is at least an hour away.
I don't know if this is helpful or not, but passing along just in case:
https://www.guinealynx.info/records/view ... 373480d0ad
Do be sure to watch for any signs of inappetence or weight loss while on the Azithromycin. We generally suggest giving a probiotic an hour or so after the antibiotic.
It is frustrating not to have access to an experienced vet. It sounds like you're doing the best you can, though. I'm in a similar situation where we live. Thankful to have our vet, who is not an exotics vet per se but has learned a lot about guinea pigs over the years; the next closest vet who knows anything about exotics is at least an hour away.
I don't know if this is helpful or not, but passing along just in case:
https://www.guinealynx.info/records/view ... 373480d0ad
Super stressed out this morning...got up early and gave Maggie a bath and haircut. Right after I gave her a treat. While eating it she has a super hard sneeze, and white fluid, very similar to what comes out of their eyes when they clean themselves, came out of her nose with the sneeze. About half an hour later, she did it again. No other symptoms whatsoever, weight is still up, but with all Maggie’s health issues I’m dreading it’s a URI, which she may have caught from Peanut. I sent the vet a message asking if I can get a refill on the antibiotic rather than bringing Maggie in, so I can just go ahead and treat her for it, because taking her in means having to take the afternoon off work. Since I work in the healthcare field, that’s extremely difficult to do these days with everything going on. Maggie has had URIs before, and usually I can tell when she’s sick before any sneezing or snot ever happens. This one is a total shock though, and I’ve never seen her have white nasal discharge before. 😔